术前预后营养指数对肝细胞癌患者经动脉化疗栓塞术术后结局的预测价值
Predictive value of preoperative prognostic nutritional index on postoperative outcome after transarterial chemoembolization in hepatocellular carcinoma patients
李刚 1易根发 1赵卫 1王俊超 1段正新1
作者信息
- 1. 昆明医科大学第一附属医院介入科,云南 昆明 650032
- 折叠
摘要
目的 探讨术前预后营养指数(PNI)对接受经动脉化疗栓塞术(TACE)的肝细胞癌(HCC)患者术后结局的预测价值.方法 回顾性收集142例以TACE作为初始治疗的HCC患者的临床资料,根据受试者工作特征(ROC)曲线确定的截断值将术前全身免疫炎症指数(SII)、PNI、天门冬氨酸氨基转移酶-中性粒细胞比值(ANRI)、天门冬氨酸氨基转移酶-淋巴细胞比值(ALRI)、天门冬氨酸氨基转移酶-血小板比值(APRI)分为高、低2组,分析其对患者TACE后结局的影响.结果 术前PNI与TACE后1周肝功能呈负相关;术前PNI、肿瘤大小是总生存期(OS)的独立危险因素,且PNI≥42.35组优于PNI<42.35组(OS 28个月vs 10个月),肿瘤大小<5 cm优于肿瘤大小≥5 cm(OS 37个月vs 11个月),差异均有统计学意义(P<0.05);而术前PNI是无进展生存期(PFS)的独立危险因素,PNI≥42.35组优于PNI<42.35组(PFS 6个月vs 3个月),差异有统计学意义(P<0.05).结论 术前PNI对HCC患者预后具有一定的预测价值,PNI<42.35组的HCC患者TACE后OS及PFS均较短.
Abstract
Objective To explore the predictive value of preoperative prognostic nutritional index(PNI)for postoperative out-comes of patients with hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE).Methods The clinical datas of 142 HCC patients treated with TACE as initial treatment were retrospectively collected.According to the cut-off value deter-mined by the receiver operating characteristic(ROC)curve,the preoperative systemic immune-inflammation index(SII),PNI,aspar-tate aminotransferase-neutrophil ratio(ANRI),aspartate aminotransferase-lymphocyte ratio(ALRI)and aspartate aminotransferase-platelet ratio(APRI)were divided into high group and low group,and their effects of TACE on postoperative outcome were ana-lyzed.Results Preoperative PNI was negatively correlated with liver function 1 week after TACE.Preoperative PNI and tumor size were independent risk factors for overall survival(OS).The PNI≥42.35 group was better than PNI<42.35 group(OS 28 months vs 10 months),the tumor size<5 cm was better than tumor size≥5 cm(OS 37 months vs 11 months),and the differences were statistically significant(P<0.05).PNI was an independent risk factor for progression-free survival(PFS).The PNI≥42.35 group was better than PNI<42.35 group(PFS 6 months vs 3 months),and the difference was statistically significant(P<0.05).Conclusion Preop-erative PNI has a certain prognostic value in HCC patients,and the OS and PFS of HCC patients with PNI<42.35 group after TACE are shorter.
关键词
肝细胞癌/经动脉化疗栓塞术/炎症指标/预后Key words
hepatocellular carcinoma/transarterial chemoembolization/inflammatory index/prognosis引用本文复制引用
出版年
2025
NETL
NSTL
万方数据